Effect of progressive resistance training on persistent pain after axillary dissection in breast cancer: a randomized controlled trial
Persistent pain is a known challenge among breast cancer survivors. In secondary analyses of a randomized controlled trial, we examined the effect of progressive resistance training on persistent pain in the post-operative year in women treated for breast cancer with axillary lymph node dissection.
We randomized 158 women after BC surgery with Axillary Lymph Node Dissection (ALND) (1:1) to usual care or a 1-year, supervised and self-administered, progressive resistance training intervention initiated 3 weeks after surgery. A questionnaire at baseline, 20 weeks and 12 months assessed the intensity and frequency of pain, neuropathic pain and influence of pain on aspects of daily life. We analysed the effect using linear mixed models and multinomial logistic regression models for repeated measures.
A high percentage of participants experienced baseline pain (85% and 83% in the control and intervention groups respectively) and by the 12 month assessment these numbers were more than halved. A high proportion of participants also experienced neuropathic pain (88% and 89% in control and intervention group respectively), a finding that was stable throughout the study period. The effect on intensity of pain indicators favoured the exercise group, although most estimates did not reach statistical significance, with differences being small.
For women who had BC surgery with ALND, our progressive resistance training intervention conferred no benefit over usual care in reducing pain. Importantly, it did not increase the risk of pain both in the short and long term rehabilitative phase.
KeywordsOncology Breast cancer Axillary lymph node dissection Pain Resistance training
GA participated in designing and executing the experiment, and in writing the manuscript. KGA was involved in designing the measurement tools, planning the analyses and in the writing of the manuscript. PEB was involved in planning the analyses and in the writing of the manuscript. CJ, NK, BZ, OH and SOD participated in designing the experiment and in writing the manuscript. CL participated in planning and execution of the study and in writing the manuscript. EWA was involved in planning and performing the statistical analyses and in writing the manuscript.
This work was supported by The Danish Cancer Society, (Grant Number R96-A6604-14-S22) and Tryg Fonden (Grant Number ID 112305).
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
The study was approved by the ethical committee in the ethical approval (H-15002714), and all procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All participants gave informed consent to participate before any study related activities were performed.
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